Neuro shelf - movement disorders

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  1. parkinson disease
    progressive death of selevted neuronal populations, mostly ventral tier of neuromelatonin-containing dopaminergic neurons of the substantia nigra. Hallmark is Lewy body
  2. Parkinsonian syndromes...

    progressive supranuclear palsy
    supranuclear ophthalmoplegia, with limitation of vertical more than horizontal gaze, axial rigidity and neck extension, early falls due to impaired postural reflexes, neck extension, and inability to look down
  3. Parkinsonian syndromes...

    corticobasal ganglionic degeneration
    apraxia, cortical sensory impairment and alien-limb phenomenon, severe unilateral rigidity, stimulus sensitive myoclonus
  4. Parkinsonian syndromes...

    diffuse lewy body disease
    early dementia, prominent visual hallucinations, extreme sensitivity to extrapyramidal side effects of antidopaminergic neuroleptic drugs
  5. Parkinsonian syndromes...

    vascular parkinsonism
    "lower-half" parkinsonism with rigidity in the legs and marked gait impairment, other evidence of diffuse vascular disease (corticospinal tract dysfunction, pseudobulbar palsy)
  6. Parkinsonian syndromes...

    multiple system atrophy
    early and prominent features of autonomic dysfunction, evidence of corticospinal tract dysfunction, cerebellar signs, stimulus-sensitive myoclonus, vocal cord paresis
  7. treatment for akathesia
    beta blockers
  8. stiff-person syndrome
    • fluctuating and progressive muscle rigidity with spasms, may occur as an autoimmune of paraneoplastic process. begins with stiffness of the axial and trunk muscles with spread to proximal limb muscles over time.
    • pts develop lumber hyperlordosis with restricted movements of the hip and spine that leads to the description of the gait as like that of tin man. paroxysmal painful painful muscles spasms proveoked by sudden movement or startle

    May be antibodies against glutamic acid decarboxylase (GAD) Tx with benzos and baclofen
  9. treatment of essential tremor
    primidone and propanolol. maybe topiramate and gabapentin
  10. treatment of chorea
  11. causes of chorea
    • huntingtons
    • neuro-acanthocytosis
    • wilson disease
    • neuroleptics
    • antiparkinsonian medications
    • alcohol
    • anoxia
    • carbon monoxide
    • hyperthyroidism
    • hyperglycemia and hypoglycemia
    • hepatocerebral degeneration
    • pregnancy
    • SLE
    • poststreptococcal (sydenham chorea)
    • caudate infarction or hemorrhage
  12. cause of ballism
    contralateral lesion in the caudate, putamen, or subthalamic nucleaus. possibly hyperglycemia
  13. treatment of idiopathic torsion dystonia
    botulinum toxin
  14. myoclonus
    sudden lightning-like movement produced by abrupt and brief muscle contraction or inhibition

    tx with clonazepam and valproate
  15. treatment of wilsons disease
    copper chelation with D-penicillamine. remeber to screen family members
  16. paroxysmal dyskinesias
    recurrent attacks of hyperkinesis with preserved consciousness

    tx: carbamazepine
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Neuro shelf - movement disorders
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